gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Management of primary orbital lymphomas

Behandlungsstrategien bei primären orbitalen Lymphomen

Meeting Abstract

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  • corresponding author Uta Schick - Neurochirurgische Klinik, Wedau Klinikum Duisburg, Zu den Rehwiesen 9, 47055 Duisburg
  • O. Lermen - Neurochirurgische Klinik, Wedau Klinikum Duisburg, Zu den Rehwiesen 9, 47055 Duisburg
  • W. Hassler - Neurochirurgische Klinik, Wedau Klinikum Duisburg, Zu den Rehwiesen 9, 47055 Duisburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.07.09

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0220.shtml

Published: April 23, 2004

© 2004 Schick et al.
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Outline

Text

Objective

Extra-nodal presentation occurs in about 40% of patients with non-Hodgkin´s lymphoma (NHL), and the orbit accounts for 5-14% of all cases. The most common age of presentation is 50 to 70 years. We present an overview of the treatment and clinical outcome of 15 orbital lymphomas, carried out in our center from 1993 to 2002.

Methods

Lateral orbitotomy was performed in 5 laterally located lesions, a transconjunctival approach in 5 medial, basal, extra-, intraconal lesions. Pterional intradural and extradural and intradural approaches (3) were used in case of intracranial involvement or location in the apex and optic canal. Two lesions of the lid or extraconal space were operated via eyebrow incision.

Results

Ten patients were diagnosed as EMZL (extranodal marginal zone lymphoma). DLCL (diffuse large B-cell lymphoma) was encountered in 2 patients, FCL (follicular lymphoma) in 2 patients, and LPL (diffuse lymphoplasmatic/lymphocytoid lymphoma) in 1 patient. All patients except 1 failed to reveal systemic disease and had a localized orbital lymphoma. 12 of the patients responded to radiation therapy with usually 40 Gy. CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy was applied in 2 patients, once in combination with radiotherapy. Local recurrence was seen in 1 patient with FCL. Systemic manifestation occurred in 1 patient with DLCL, undergoing ICE (ifosfamide, carboplatin, etoposide) chemotherapy with complete remission.

Conclusions

The course of orbital NHL is variable and requires a multidisciplinary treatment. Radiotherapy is effective in indolent forms, chemotherapy is applied in aggressive lymphomas. Surgical biopsy should be performed via the adequate approach according to the location and extension of the lesion without additional morbidity.